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Shoulder pain is quite common in our society and interesting enough the symptoms of shoulder pain remind me of a light switch.

Your symptoms are either “on” and you most likely experience pain in the shoulder with an inability to raise your arm in the air properly, or “off” with no shoulder pain and complete function to raise your arm any way that you choose.

In fact, one day you could be playing with your kids or playing a sport without any difficulty and hours later have no ability to lift your shoulder which is completely debilitating.

At PTN we handle the diagnosis and treatment of a wide variety of shoulder problems, and all of them are different. There are no two shoulder problems that are the same just like no two finger prints are the same.

We get a lot of questions asked like: “Why can’t I swing my golf club without shoulder pain anymore?.” “Why does it hurt to throw a baseball?”, “Do I need to stop lifting weights?”. ” Do I need surgery?” These are typical questions that we are asked every day.

In order to explore how to completely eliminate shoulder pain naturally without the need for medication and surgery, let’s take a look at the top 5 reasons that people develop shoulder pain.

#1) Rotator cuff weakness– A lot of problems begin with the lack of internal and external rotation strength. Basically, these are the muscles that hold the ball in the socket. When they get de-conditioned, they get weak and the ball doesn’t move around too much in the socket. This leads to the pinching of nerves and damage to tissue that is used to hold the shoulder in place.

There are a lot of people who exercise with a personal trainer who also come into one of our 4 orthopedic clinics. They continue to have shoulder problems and they will ask: “You know, I work my delts, I work my back. Why am I still getting shoulder pain?” “Is this something that is different than all the muscles that I normally work with my trainer?”

The answer is: Absolutely, yes! Basically, when you work out in the gym and you see a lot of people doing shrugs, overhead presses, even bench press but they still have shoulder pain that may seem to be getting worse and worse. The reason for this is the big global muscles in your shoulders are being strengthened but they can not do the job of the smaller muscles (rotator cuff) that lie deep beneath the bigger muscles. What we’re after here, especially in therapy, is to prevent pain and dysfunction through strengthening the stabilizer muscles and creating the proper movement of these little muscles, that lie underneath those big trophy looking muscles you have.

#2) Scapular instability– There are two flat large bones located on your back that aide in moving the shoulder upward and outwards. The muscles that control these bones may become weak and may overstretched. As they pull your shoulders forward and downward they put stress on the shoulder pinching off nerves and the rotator cuff muscles. So then every time you go and try to move your arm up and down, you get pain and pinching of these delicate structures.

#3) Posture -If you have poor posture you often find yourself in a position where your shoulders are rounded and forward. This would be expected if you’re sitting at a desk, hunched over a computer. When your shoulders are rolled forward this creates limited rage of motion for your shoulder when you’re lifting your arm up overhead. As you try to lift your arm up this way, some of your rotator cuff muscles get pinched between bone. When those muscles get pinched, they become very tight, inflamed and very irritated.

#4) Overuse syndrome-Definitely number four would be overuse, repetitive use. We have a lot of tennis players, young, old, all ages, all skill levels, really. A lot of baseball players. A lot of overhead athletes, and even swimmers perform the same motions over and over creating stress at the muscles and the shoulder joint leading to increased pain and discomfort.

It would be fair to say, that even if you are not immediately experiencing shoulder pain you may have some structures that are tight, and some that are loose, like in a swimmer with that forward rolled shoulder position. You may not have pain right away but when those muscles are imbalanced you are likely to develop an overuse injury. That is when it is too late and when pain symptoms begin.

#5) Cervical spine problems–Number five, believe it or not, actually isn’t coming from the shoulder at all. It’s really coming from your neck. Neck problems are probably, well definitely one of the biggest causes of shoulder problems that I see in the clinic. People will come in after a car accident, after a football injury or anything, even just sleeping wrong. They’ll start to have pain down their shoulder, into their arm muscles, or even down into their fingers. Although this pain is presenting as shoulder pain, it can be coming from nerve entrapment at the neck. So a detailed assessment of the neck has to be considered in an overall strategy of resolving shoulder pain.

There is a lot of debate about when to use orthotics. In our practice we have observed successful use of orthotics when certain criteria are met. Most of the time orthotics are considered to be a good option after changes in someone’s body can no longer be corrected with a combination of stretching, strengthening, joint mobilizations, and functional training. One misconception about orthotics is that they are just for correcting the feet. We have been very successful with eliminating knee, hip, low back, and even shoulder pain due to correcting postural or improving faulty biomechanics. As mentioned above we never recommend orthotics until natural changes in the body occur first. But there are times where structural deviations warrant orthotics as the first recommendation.

So you might be a good fit for orthotics if you fit into these quidelines:

First, the right orthotic should be comfortable and fit correctly. Every person has an individual orthotic fit. The price of the orthotic does not always play a role in the fit. At our offices we are able to accomplish creating good custom orthotics without hassle, waiting for molds, or making many corrections.

More importantly the orthotics are very durable, cost friendly and accomplish changing the unfavorable foot biomechanics that we are looking to resolve.

Lastly, all orthotics need to fit the lifestyle of the person or the intended activity use of the orthotic. If a person is a high level tennis player they would need a completely different orthotic then someone who is using their orthotics for a 9am to 5pm job in an office.

Regardless of the orthotic the underlying condition of the individual must be considered first. If you would like to have afree 30 minute conversationabout whether orthotics might be right for you thenclick here.

If you would like more information about how to end low back, neck, shoulder, or knee pain without medication, shots and surgery then please feel free to click on our free e-books or visit our other blog posts.

There are many exercises for low back pain and sciatica for those suffering from these conditions in and around Pittsburgh but there are 3 that tend to help in a general sense.

Now, doing a few exercises WILL NOT cure your low back pain and sciatica because the only way to eliminate your problem is to schedule a comprehensive exam to find out a diagnosis and establish an individualized treatment plan for you.

There are so many times that people are given exercises with the expectation that when they do the exercises your pain will be reduced and this will take care of their problem. This couldn’t be further from the truth. In other blog posts we have talked about how each person is like a snowflake, no two are alike. The same goes when someone is experiencing low back pain sciatica.

Someone who has the same diagnosis as another person will not have the same symptoms, will not responded the same treatments, and is completely different than someone else. There is no “one-size-fits-all”. This is why it is imperative to be seen specifically for your condition.

Many of our patients have an active lifestyle which may include upper level strengthening involving full body movements or “functional movements”. In our clinics the squat is considered a Stage 3 exercise for low back pain. Stage 3 exercises involve full body strengthening after issues such as pain and numbness, decreased lumbar range of motion, and initial spinal stabilization exercises have been resolved. This third stage is required to return an individual from the critical steps of basic rehabilitation to functioning in life. The body never contracts muscles alone or move joints without a coordinated sequence of neuromuscular events involving many body systems. So should you return to squatting after a lumbar injury? “YES.”

How should I start to squat?

You should never begin squatting without the help of a professional. In our clinics our specialists examine your form and teach you how to perform this activity properly. In fact, it may take years to master your squat. This exercise requires constant self-correction to avoid lumbar injury. You will also need to be evaluated for lumbar spine and lower extremity flexibility, joint motion, and lower body strength. If you would like to learn the proper way to squat with us click here.

Squatting should mimic the bio-mechanical motion of performing a sitting <->standing motion. A person’s center of gravity should fall upon the natural curves of the spine, hips, knees and ankles that were made to receive weight bearing activity. When pressure from a barbell or weight falls outside of these very special places then the body may take on stresses that tend to injure rather than provide anabolic activity.

When a person’s center of gravity is translated over their base of support at the bottom position of a squat then this exercise becomes highly productive to build strength and balance.

But what if I can’t even walk right because my low back pain is so bad?

Then you are not ready to squat. Period. If you are feeling any pain in your low back, numbness and tingling in the legs, or can not walk without low back pain then squatting should not be performed. You need to perform Stage 1 and Stage 2 rehabilitation with our physical therapists. These stages sometimes involve spinal mobilizations, specific flexibility, spinal range of motion and muscle training. If you would like to have a free 30 minute conversation about your specific condition and how we might be able to help you then click here.

If you would like to read a free book on the 14 best kept secrets to eliminating back pain and staying pain-free then Click Here